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Children with flat feet, also called pes planus, have a flattening of the arch during standing and walking.

Flat foot is normal in infants and young children. At this age, in the absence of any associated symptoms, treatment is highly debatable.

Flat foot usually naturally corrects itself as muscles strengthen and soft tissues stiffen. The height of the arch in the foot increases with age until about 9 years. The problem is when flat foot persists, spontaneously occurs in older children or later in life, or is associated with pain and disability.

Flat feet can be flexible or rigid, painful or painless and associated with a tightness of the calf muscles (Achilles tendon). The majority of flat feet are painless, but when pain is present it is usually during weight-bearing activities such as walking and running. The pain can be in the sole of the foot, the ankle, or non-specific pain all around the foot area.

What causes flat feet?

A complex and sophisticated interaction of bones, ligaments, muscles and nerves within and above the foot defines its anatomy and function. Anything that interrupts the integrity of these structures leading to a collapsed arch can cause symptomatic flat feet.

Examination of the foot begins with an examination of the entire child, because the flat foot may have an underlying cause.

Flat foot can also originate from unusual anatomy such as a tarsal coalition (bones joined together), ligament or muscle damage, restricted ankle movement, outward rotated lower legs, and knock knees (where the legs bow inwards at the knee). Obesity can result in collapse of the arches by the increased load on the foot. If knock knees also develop, the middle of the foot will tend to turn out (abduct). The foot will point outwards when walking, instead of straight ahead, which is inefficient and can cause early fatigue.

Footwear in early childhood has been thought to cause flat foot. It is likely that children who wear shoes, are not physically active and have flat feet will have decreased muscle activation in their feet and thus impaired foot function and weakness.

Some older children and adolescents develop flat feet in the absence of any disorder or associated factors.

Does flat foot need to be treated?

Flat feet require treatment only if clearly associated with pain or decreased function. Managing the underlying cause or disease is of highest priority; just treating the symptoms should be secondary.

If flat foot is observed in a child who is overweight and has knock knees, or in a child with excess joint flexibility and poor footwear, each of these factors could be contributing to the symptoms, and each should be addressed.

If a child’s quality of life is affected by how their feet look, feel or function, then the associated issues should be addressed.

There are many causes of leg pain right from muscle cramps and inflammation of tendons to arthritis, varicose veins and nerve damage. Leg pain due to muscle strain following an injury or wearing tight shoes for a long time can be prevented by following few simple tips:

Stretch the leg muscle: One of the most effective ways to prevent leg pain due to a sudden muscle twist or cramp is to stretch the muscle. This not only improves blood flow to the injured muscle but it also helps in reducing muscle tension thereby relieving muscle soreness.

Take a warm shower: If you suffer from leg pain, then take a warm shower to relax the muscles. If taking a bath is not feasible, then placing a heating pad on the affected areas can also help. A heat pack works best if the pain is due to a previous injury as it not only relaxes blood vessels but also improves blood circulation, alleviating leg pain.

Wear a proper fitting athletic shoe: Most people fail to choose the right fitting shoe, which is one of the common causes of leg and heel pain. To get the right fit, determine the shape of your foot using the ‘wet test’. For this, step out of the shower onto a surface that will show your footprint, like a brown paper bag. If you have a flat foot, you will see an impression of your whole foot on the paper. If you have a high arch, you will only see the ball and heel of your foot. When shopping, look for athletic shoes that match your particular foot pattern.

Choose the right sports shoe: Not many people are aware that different types of shoes are specially designed to meet your sports requirement. Did you know running long distances in court-style sneakers can contribute to shin splints? It is important to choose the shoes according to your sport or fitness routine.

Go slow if you are a beginner at the gym: One of the common mistakes that most people commit is to overexert on the first day of the gym, which not only exerts pressure on the knee but also causes muscle soreness and leg pain. The key to preventing leg pain and sticking to your workout routine is to build your fitness level slowly. You can start off with less strenuous workouts and then gradually increase the duration, intensity, and frequency of your exercise regimen.

To avoid in-store arguments, parents and children should discuss in advance the style and brand of shoes they want to look for.

Remember that a good fit is more important than the size of the footwear. A good fit allows for a 1/2” of space between the end of the toes and the end of shoe. Shop at retailers who provide a fit specialist for extra assistance.

Remember that not all shoes of the same size fit alike. While foot measurement is a starting point, how the shoes fit is more important.

Match the shape of the shoe to the shape of the foot.

Remember that while a low arch is normal in young children, in children older than age seven, the lower the arch the more important it is to have shoes with good support. Look for a firm heel counter and stiffness when trying to twist shoes lengthwise.

If a child wears orthotics, select shoes with removable foot beds and try the shoes on with the orthotics in place.

Remember that price is not necessarily commensurate with quality. If price is a consideration, last year’s models can offer all the features needed at a discounted price.

Check the fit on your child’s shoes on a regular basis as children’s feet grow at irregular rates.

For more information, or if you have any questions, contact The Podiatrist

The importance of our feet has been understood for centuries. Even the Greek philosopher Socrates is reputed to have said, “To him whose feet hurt, everything hurts.” So, what comprises foot care that promotes comfort at any age?

Wear shoes and socks that fit and are comfortable.

Be sure your toes are not cramped.

Change socks daily and if possible have two pairs of shoes in everyday use so that you can alternate the pairs daily.

Elastic laces are handy if your feet swell.

Shoes should be worn that cover, protect, provide stability for the foot and minimize the chance of falls.

Whatever your age – student or grandparent – foot care is important.

Remember to cut or file your nails straight across and never shorter than the end of your toe.

If you are older, and particularly if you are diabetic, it is helpful to get The Podiatrist to do your foot care.

It is best to wash feet daily and always test the water’s temperature beforehand. Pat, do not rub, your feet dry and remember to dry between and under the toes. If your feet are bothering you you’ll find that short soaks of even ten minutes are soothing.

Use a lanolin (ointment base) moisturizing cream for dry and cracked skin. If your feet perspire, dust lightly with talcum powder. Remember to remove excess cream of powder from between your toes to avoid skin problems. If you are diabetic it is wise to examine your feet daily.

Exercise each day if possible. Walking is always good but there are also special foot exercises that can be done like rolling your feet over a rolling pin several times daily or picking up a crumpled towel with your toes.

Despite reasonable care throughout life, however, the older foot is subject to problems. Heredity is a factor as are the stresses over the years and complications from systemic diseases. It has been estimated that at least 80 percent of people over 50 have at least one foot problem.

The most common are corns and calluses, ingrown toenails, bunions, hammertoes, strained arches, heel pain and arthritis including gout.

In many cases there can be improvements jus by switching shoes to the type with wider, box-type toes. Also. shoe size can actually change with added years.

Feet carry our body’s weight, help hold us erect, co-ordinate and maintain balance in walking. We need to give them tender, loving and skilled care.

When the weather gets hot, the shoes come off. Walking around in flip-flops, sandals or even barefoot can feel great, but it can also hurt the skin on your feet.

As we get ready for the summer , prepare to bare your soles with our SOS guide to putting your best foot forward.

Killer HeelsHigh heels force the weight of the body onto the ball of the foot, which can cause a build up of callus and bunions and an increased incidence of corns under the metatarsal. ‘Posture is affected as the body is thrown forward and the spine can become mis-aligned which can lead to a painful back, hip and knees. Repeated high heel wearers are also prone to shortening of the Achilles tendon making walking on flat surfaces without heels painful.

Top tip: Heels are fine if worn in moderation, but it should be remembered that pain is an indicator that something is wrong! Vary the style of shoe from day to day (platforms or wedges are better than stilettos despite the height of the heel). Gel insoles are also good for reducing pressure on the ball of the foot.

Flat OutFlat shoes can pose as many risks as high heels. Wearing completely flat pumps puts the feet at risk from pain as there is no shock absorbency and little support. Another problem can be corms and calluses as pumps are often worn a size too small in order to keep them on the foot. Flip-flops don’t fare much better either. Research has shown that flip-flop wearers take shorter steps resulting in a higher risk of joint and muscle pain. Added to this, wearing flat shoes can stretch the calf muscles and Achilles tendon especially if used to wearing heels.

Lumps and bumps

Calluses: A callus is an area of toughened skin developed in response to repeated contact or pressure and is one of the most common foot problems. Generally pain-free (although they can produce a burning sensation), they can lead to more serious problems such as underlying tissue damage if left unchecked. Prevention is the best cure and wearing shoes that fit properly is the first port of call.

Corns: A corn is essentially the same thing as a callous only it is a more localized thickening of the skin which appears as a cone-shaped mass and is most commonly found on the toes. Seeking professional assessment from The Podiatrist is highly recommended.

Cracked Heels: More of a cosmetic problem than a serious concern, cracked heels often affect people who have naturally dry skin and is exacerbated by lifestyle factors such as standing for long periods of time.

Bunions: Tight fitting shoes are thought to be the cause of bunions in about 90 per cent of patients although they can be inherited. Most people experience them as a bump on the base of the big toe but as they develop the big toe begins to angle in towards the other toes. The solution? Be careful with shoe styles if you know that you are developing one but once developed surgery to realign the metatarsal is usually required.

Ingrowing Toenails: This is a painful condition that occurs when the nail starts to press into the fleshy art of the adjacent skin. It can easily become infected and needs professional podiatry treatment. Badly cut toenails and ill-fitting shoes are the most common causes.

Growing pains in younger athletes are common occurrences. Being able to recognize which aches and pains may be related to growing and which may be of concern, however, is not always that easy.
All kids are going to grow, and some grow more rapidly than others. A lot of development and growth happens from age 10 through high school. Some kids are early bloomers; some are late bloomers. No matter when a kid begins and ends his or her growth spurt, many of the aches and pains associated with growth can occur in the same general area.
Two common areas are the knee — specifically the area of the tibial tuberosity — and the heel of the foot. The tibial tuberosity is the spot located just below the knee joint where the patella tendon inserts itself onto the tibia. The area of the foot at the base of the heel is where the Achilles tendon inserts itself to the calcaneus bone.
The rate of growth and activity level can sometimes determine how much pain a young athlete might have with these growth spurts.
To put it into better perspective, a person can think of the patellar and Achilles tendons as rubber bands. When bones grow, these rubber bands stretch. When there is rapid growth, the bands can’t always grow or stretch as quickly as the bones do. Therefore, you get an increased amount of tension and pain in the areas where the muscle tendon attaches to the bone.
Now factor in activity level. In a young athlete who is playing a number of sports, these growing pains can become quite severe because of the extra stress placed on these two areas. A less active individual might not have as many aches and pains.
So how do you treat the minor aches and pains, and what can happen if they go untreated and continue to get worse?
The most conservative treatment for the general pains is simple: see The Podiatrist, rest, ice and stretching.
For active individuals, finding time to rest is extremely important. Having young athletes in activities every night of the week and on the weekends is a recipe for disaster. Young athletes need time to rest, especially if they are experiencing some general knee or heel pain because of growing.
If young athletes try to push through that pain, they can end up with more severe injuries – usually starting in the form of tendonitis. If the stress and tension become too great, an avulsion fracture can develop in those areas. Basically, the overstressed tendon will start to pull away from the bone and take some of the bone with it. This type of injury will really limit the person’s level of activity.
But really, it all comes down to being smart about it. Young athletes and parents of young athletes need to understand that rest is important and make sure rest days are exactly that.
Being smart and addressing the minor aches and pains with some early conservative treatment can make a huge difference in keeping a young athlete healthy while he or she is growing at a rapid rate.
See The Podiatrist for any of your foot problems.http://www.thepodiatrist.comhttp://www.kidsnmotion.co.nz

Walking is the major achievement of kids this age and over the course of the year they’ll get much better at it.
As kids’ mobility improves, so does their ability to investigate where they couldn’t before. Once again, take a look around your home from a kid’s vantage point and update childproofing measures to keep pace with your child’s advancing skills.
How Is My Baby Moving?
Though some babies take their first steps before their first birthdays, most children learn to walk well in the months after they turn 1.
Kids who are learning to walk are called “toddlers” because that’s exactly what they do — they toddle, keeping their legs wide apart and seeming to hesitate between each step, jerking from side to side as they move one foot forward, then the next.
About 6 months after taking the first steps, toddlers develop a more mature gait, holding their hands at their sides (rather than out in front for balance) and moving with their feet closer together. They also tend to move their feet in a way that looks more like walking — moving from the heel to the toe.
During these months of practice, most toddlers take a few spills, but this is part of learning to walk. You can’t protect your youngster from every fall, but you can reduce the risk of injury by keeping exploration in areas with soft carpeted surfaces and away from sharp corners of furniture.
To get back up from a fall, toddlers often place their hands out in front, lift up their bottom, and then pull their feet under. It may not look very graceful, but it works.
After walking for a couple of months, your child will begin to feel more confident about walking and take on new challenges — such as picking up and carrying objects, moving while pulling a toy behind, and climbing stairs.
By the middle of the second year, your child may learn to run, start to kick a ball, and even attempt to throw a ball overhand. By 2 years, your child may jump in place.
As kids develop the ability to move, they’re also learning. You’ll notice that your child seems extremely interested in finding out how things work, so offer safe opportunities to do this.
Helping Your Child’s Development
Give your child lots of things to do and see in this new upright position. Take walks around your yard or through the neighborhood together or hold hands and climb up and down the stairs together. You can even make an obstacle course of pillows or boxes and encourage your child to walk, climb, and crawl through it. Buy a few balls for kicking and throwing.
Experts recommend that toddlers should:
accumulate at least 30 minutes daily of structured physical activity like playing on the playground, going for a walk, or being in a parent-and-child tumbling class
also have at least 1 hour of unstructured free play each day when they can explore and play with toys
not be sedentary for more than 60 minutes at a time, except while they’re sleeping
have indoor and outdoor areas that meet or exceed recommended safety standards for all of their activities
As their physical skills develop, toddlers also learn to use their hands more. Toys and objects that can encourage this include:
paper and crayons
sculpting dough
simple stacking toys that kids can build up and knock down
simple puzzles
When to Call The Podiatrist
Normal child development follows a certain pattern, and the skills that babies develop early are building blocks for later skills. But the time it takes for kids to develop them can vary widely.
See The Podiatrist if you child is having problems:
walk by 18 months
walk in a more mature pattern after several months of practice
walk any way but on the toes
climb stairs while holding onhttp://www.thepodiatrist.co.nzhttp://www.kidsnmoton.co.nz

Many parents underestimate the importance of their children seeing The Podiatrist regularly. Just as they see a dentist to keep their teeth and gums healthy, children should see The Podiatrist to ensure that their feet and ankles are developing normally. This is especially important for kids who play sports where lots of running or footwork is involved.

During a recent exam, an eight year old patient complained of heel pain, particularly after playing sports. It had worsened over the last few months, and her mother thought it might be plantar fasciitis. In fact, it was osteochondroses, also known as Sever’s disease. Simply put, this condition usually occurs in overactive children who have tight Achilles tendons. The pain results from the repetitive pulling of the tendon on the growth plate in the heel bone.

Treatment of Sever’s disease often consists of immobilization, anti-inflammatories, and stretching before and after activity. Orthotics or a heel pad will also help decrease the tension of the Achilles tendon on the heel. Spontaneous resolution occurs when the growth plate closes as the child grows.

Thankfully, we were able to diagnose the patient’s condition and treat it accordingly. She now has less pain and can prevent injury as she grows. Eventually, this pain will most likely go away on its own.

If you think your child has any foot problems, contact The Podiatrist.

The saying it take a village to raise a child may be true. We are here to help you care for your child’s feet and set a good example. Prevention is very important when it come to the health of your child, and this includes feet! Check out these ten tips for caring for feet

Look carefully at your newborn’s feet. Lookout for abnormalities and make sure they get checked out and treated before they become a serious problem.

7. Buy shoes that fit well. Kids feet should be every time shoes are purchased because they grow so quickly.

8. Prevention- Don’t allow your child to walk barefoot outdoors or in areas where sharp objects may be on the floor. This will prevent foreign objects from entering your child’s foot and causing pain and injury.

9. Cover Cuts- Wash and cover cuts until they have healed.

10. Set a Good Example- Take good care of your feet and your child should learn by example.

If you notice any abnormalities in your child’s feet, be sure to schedule an appointment with The Podiatrist.

Whether you take a leisurely jog or sprint to the finish line in a marathon, running is great exercise. In fact, running is one of the easiest and most popular sports among non-professional athletes.

Running offers many benefits, including improved cardiovascular and respiratory function, weight loss, reduced cholesterol and increased muscle and bone strength, as well as a healthier mental outlook. But with any sport or activity comes the risk of injury.

Runners of all levels are at risk for significant injuries to their hips, knees, legs, ankles and feet. One of the best ways to prevent injury is to avoid injury. By taking simple precautions and watching for signs of potential problems, individuals can prevent or minimize many injuries.

The majority of injuries are caused by excess — running too far, too fast or too often. In addition to strains and sprains, blisters and cramps, some of the more common injuries include:

·Hip and thigh injuries — Bursitis, stress fractures, and hamstring pulls or tears are typically caused by inflammation and strain from overexertion or
improper running techniques.

·Knee injuries — Patello-femoral syndrome, more commonly called “runner’s knee” is characterized by a dull ache or sharp pain under or around the kneecap and is often accompanied by a grinding sensation when the knee is bent then straightened. Iliotibial Band (ITB) Syndrome can also produce inflammation and pain in and around the knee.

·Leg injuries — Shin splints or medial tibial stress syndrome is a cumulative but painful condition resulting from too much force being placed on
the shinbone (tibia) and surrounding tissues.

·Ankle injuries – Sprains vary in severity but typically result in pain, swelling and bruising. Achilles tendonitis is a painful inflammation in the back of the ankle, which if left untreated, can lead to a ruptured tendon.

·Foot injuries — Plantar fasciitis, which can cause sharp pain or a dull ache in the bottom of the foot near the heel or in the arch, is typically caused by poor foot structure, inadequate running shoes or a sudden increase in the distance run. Improper shoes and downhill running can also cause painful Runner’s toe.

The good news is that these injuries are treatable, but more importantly can be prevented or minimized by following some basic training guidelines and running techniques.

Some tips to help you

Invest in a good pair of running shoes. Running in worn out shoes is a prime cause of many injuries. Make sure to replace them when you’ve logged about 600 kms.
Stretch regularly before and after you run to avoid tightening of muscles. Be sure to include stretches for the hips, thigh, hamstring, calf and ankle, as well as the back.

Perform warm up exercises such as light jogging or sprinting prior to engaging in a full run.

Include cross training in your overall exercise regimen to help strengthen a wide range of muscles. Consider activities such as weight-training, swimming,
calisthenics or those exercises that use muscles in slightly different ways.

Avoid overtraining – and overexertion. Doing too much, too soon and too quickly can lead to injuries. A good approach for beginners may be to start with a
run/walk technique, alternating thirty seconds of running with thirty seconds of walking for about twenty to thirty minutes, three times a week. Gradually,
increase the length of running segments while keeping them at a manageable pace.

· Stay hydrated especially in warmer weather. Drink at least 1 ½ cups of water 10-15 minutes before running and every 20 minutes during.
· Run on smooth, even and softer surfaces whenever possible. For example, asphalt roads are a better choice than concrete sidewalks.

· Watch for the warning signs of injury. If you begin to experience pain or swelling, stop running and seek medical attention. Depending on the type and extent of injury, treatment may include RICE – Rest, Ice, Compression and Elevation; taking anti-inflammatory medication (aspirin or ibuprofen); and taking time off from running.

– Seek professional advice from a Podiatrist if you are injured or have any concerns